148: Meditation, Nutrition, Functional Medicine, and De-Stressing Your Body - with Dr. Vincente Pedre
November 21, 2019
Welcome back to the podcast! Today’s guest is Dr. Vincente Pedre. He is Medical Director of Pedre Integrative Health and President of Dr. Pedre Wellness. He is a Board-Certified Internist in private practice in New York City since 2004. He is a Clinical Instructor in Medicine at the Mount Sinai School of Medicine, as well as certified in yoga and Medical Acupuncture. His unique combination of medicine is best described as integrative or defined by a functional, systems-based approach to health. Enjoy!
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Hey, guys, I'm so excited for today's podcast and today's guest, he is the medical director of Pedre in Integrative Health and he's president of Dr. Pedre Wellness and he is a board certified internist in a private practice in New York City since 2004. He's written an amazing book called The Happy Gut Book, and he's got some amazing happy gut supplements. Welcome, Dr. Vincent Pedre.
Thanks for having me. It's great being here.
And so I know that you were in New York City during 9/11. Can you discuss with the listeners how that impacted your approach to medicine and wellness?
Well, up to then, I had been training in internal medicine at Mount Sinai Hospital in the Upper East Side. And first of all, it really, I think, impacted the entire city. But as a doctor, you kind of have this feeling like you want to help, you want to do something. And there was really no one to help because most everyone died when the buildings collapsed. And it was really sad. Our hospital got one person out of the we were number seven in the the triage chain of where people would be taken. But I wanted to contribute in some way and ended up becoming part of the World Trade Center worker screening program.
And that was part of the group that launched the program. So I was pretty much the ground up. And I also helped launch the Spanish part of the program. And I created a basically translated all of our questionnaires to Spanish. But what it really did for me is an internal medicine. You're thinking about organ dysfunction and you've got a lot of chronic diseases, but you don't really think about how our environmental exposures other than maybe like allergy asthma, like you were thinking that. But you don't think about the toxic exposures in our environment and how they can affect our health. So the one thing that it did for me is it really opened my eyes to that whole concept of toxicology and that our environment can actually be one of the triggers for disease in people. And we saw a lot of people with chronic respiratory issues who had worked in the recovery effort after the World Trade Center. I don't know if people remember, but there was a smoldering fire that went on for a couple of months that they couldn't put out. And they were working on that for months after. And there were a lot of people that I saw actually were asbestos remediate. They were doing the best, those remediation. So they were wearing all sorts of masks and stuff, but they were still coming in with a lot of symptoms that you could attribute to inhaling fine particulate matter, which we know is is extremely bad for the lungs, but also for the circulatory system.
And and then just it just really opened my eyes to looking at things a different way.
And funny enough, during the World Trade Center, while I was working on that project, I had so much extra free time because now I had finished my residency. So I wasn't working one hundred hour, weeks now. I was working 40 hour weeks. And when you when you go from one hundred hours to 40 hours, it feels like you have all the free time in the world because you're not spending overnights in the hospital. So I was really curious about yoga and I had been doing yoga since before medical school and had an incredible retreat that I went to on vacation in December of that year.
This was two thousand and two. And I had it reminded me of how important yoga was that I came back to New York and I did a yoga teacher training. And what that did for me is even while I was doing the the World Trade Center program really started looking at how people were breathing and how they were holding their body in space, because a lot of people slouch. And when you slouch, your diaphragm doesn't have the space to move. So then you don't have the space to really inhale properly and aerate your lungs. So it was it was a time that I really started looking at the body holistically.
And it gave me that opportunity to do so because we were doing this comprehensive screening, looking at what whatever health effects might come up, I mean, a lot of it was respiratory system for people exposed to the World Trade Center post 9/11. And a lot of it was mental, emotional, like a lot of PTSD trauma just from having had to work there and knowing what happened. And it was a really tough time, but it was wonderful for me because it it allowed me to give back in a way that made me feel like I did something in response to that. And it also taught me that I really wanted to get back. I mean, this was a research program. So there was at the time when I did it, there was no clinical follow up for these patients because we had just we basically had the seed money to set up a screening program. And then we would tell them, hey, this is what we suspect is wrong with you. And we think that some of these things could be related to your exposure to the World Trade Center. Take this to your doctor, take this to an ear, nose throat specialist and go get treated. But we didn't have follow up like that. We didn't know like we had screened and then we sent them off. And but the the amazing thing is that that program is still going on. And I know they're looking at things like they're increase in cancer rates from the exposures. I know I've had patients who were living downtown who were diagnosed with cancer a few years after 9/11 with lymphoma. And you have to wonder, you know, was it the toxic exposure? But now they have the funding. And since then they were able to actually create a clinic where the patients are not only screened, but also followed up with the anti and they have mental health. So it's much more comprehensive than when I was involved, but I was part of the team that basically kicked it off the ground with the initial federal funding.
Wow, that's awesome. Well, what I love is that you're board certified. You came from traditional medical practice and now you've moved into more of a functional and integrative medicine practice. Do you still have your traditional medical practice? And how do you kind of marry the two together?
See, I don't see any of it as separate. I think that true medicine is a marriage of all the best aspects of Western medicine and and what it has brought because there are life saving medications out there. There are moments when you have to use an antibiotic.
The difference is, is that if I'm putting someone on an antibiotic, let's say, to treat Lyme disease because they have a tick bite, I'm also thinking about how I'm going to created this bioscience, basically an imbalance between good and bad bugs in the gut.
And I could also trigger a yeast overgrowth by putting them on long term antibiotics for several weeks. So I'm my toolbox is super wide. There's a lot of things that I can do for people and I can reach on both sides of the fence. But for me, it's really the marriage of the two because there are moments when you do need traditional Western medicine. But what's different about what I do is that I'm also talking about mindfulness and meditation and stress relief and diet and nutrition and what supplements to take and what supplements not to take. So to me, it's not that there is a separation. There was in the beginning when I first started practicing and then eventually there reached a moment where everything just started combining and then it just became fluid. And really, I only know how to practice medicine one way. And it's really the the melding of these these two. I mean, I don't regret that I trained in Western medicine. I wonder if I were as me now as my forty six year old self, knowing what I know, I might have chosen to go to a naturopathic medical school instead of traditional allopathic just because that was always what called to me. I started doing yoga meditation before I got into medical school and I continued it all throughout medical school. It shaped the type of doctor I became. It allowed me to handle the stress of medical school when my fellow classmates were super stressed and having sometimes, you know, mental breakdowns or not sleeping. And I was known as the Zen guy. And back then, this is mid 90s, I was meditating, but I didn't tell my class. It's that I was meditating because meditation was not in back in the mid 90s, you know, so I almost felt a little bit embarrassed because I was doing this thing that's kind of out there. But at the same token, I knew that it was actually helping me deal with the stress of medical school better than my classmates. I was I always felt pretty relaxed and I found and that's what really kept me there. And I knew that even though the entire time that I was in a traditional Western medical school, that the type of medicine I was going to practice was going to incorporate all of these aspects.
That is awesome. We've had some I know you focus a lot on gut health. And so if you had to name your top three tips to have a healthy gut, what would they be and why?
OK, yeah, I was I was thinking about this this morning because people might think that my top tips might be like, eat a certain food or don't eat this certain food. But I think the the really important message that a lot of people need that is missed in creating ideal good health is, first of all, slow down. Everybody's eating rush that their desks, they're in the middle of their workday, they don't take a moment to breathe, and then my patients tell me my lunch doesn't sit well with me. And I ask them, well, how did you eat it? Actually, don't tell me. I'm like, let me guess. You're at your desk and you're eating it as fast as you can in five minutes while you have like more than one computer screen going and you're doing like five different things. Like, yes. Like, well, how can your body actually accept and taken the nutrition if you are not in a relaxed state, your body's in a stress state and that state, your body is not in rest and digest mode. It's in a run and alert mode. So it's not going to make the amount of digestive juices that you need in order to digest your food. It's not going to allow the easy intake of those nutrients. But also eating too fast is already missing one important step in the digestive process, which is the mechanical breakdown of the food in your mouth, which most people just don't do well enough. So my number one tip is of my top three tips is slow down and really take time, you know, even tell my patients, take three deep breaths before you start eating to reset the tone. And honestly, do are you really more efficient doing work while you're eating or would you actually be more efficient if you take a moment to allow yourself to relax and then get back to work? I mean, I think you're more efficient when you allow that that demarcation. And if you can actually step out of the office and go for a walk or eat outside, I love when the weather is beautiful. I live in New York City, but when the weather is beautiful, there are plenty of places near my office where you have outdoor seating and I'll go and sit outside, I'll bring my lunch or I'll I'll buy a salad. And that moment is just so precious for me because it's an unwind period. And then I can go back and I'm fresh and ready for the afternoon. The the second tip is also probably not what people would expect to have a happy gut, but you want to create feelings of wellness in your body. And for me, one of the key ways to do that is to express gratitude. And if you think about the gut brain axis and the gut being kind of like your your non-verbal feeler, we would call that gut intuition. It's it's taking in the world, but it's taking it in in a way that doesn't come with words. But you get that intuition that you should do this or not do that. And I really do believe that if you can get into a space of gratitude, that that helps rebalance your sympathetic parasympathetic nervous system and helps you get into a more relaxed state which is so necessary for not just healing the gut, but healing the body. Know it's so easy to get into our story of woe is me. My life is horrible. I have this chronic pain. If even within that, if you can find gratitude for what is still good, you know, and you can do that every day, even if you could write it like have a gratitude notebook, I mean, I challenge people to do this and tell me that it doesn't change their life and their perspective on everything, because when whatever you focus on gets bigger, if you're focusing on everything that's wrong, that's going to be what you experience every day, because that's where your attention is. If you start focusing on what is good, what is great in your life, then those pieces start to magnify. And I think it can really help balance out your health in many ways. And my last I guess my last I guess there's a theme to these top three tips. My last one is to take time to destress. I think it's really key and important in our modern society and our very fast paced social media, Internet world to really carve out offline time to destress, whether that is meditation, whether that is knitting, whether it's going to a yoga class in community or going on a hike in nature. I mean, for me, it's about finding what speaks to the person. It's not about being dogmatic about do this. Even though we know and I do tell a lot of my patients, there's so much research showing that meditation will rebalance your parasympathetic and sympathetic nervous system, the fight or flight of the relax, the part of the nervous system that keeps you relaxed. And from 20 years of being a doctor, I can say that I really do believe that the body cannot heal if it is not in a relaxed state. And there are two levels of stress. There is mental stress. And then there is what I call biophysical stress. So you might feel that I'm great. I can handle all pieces of my life. I'm not mentally stressed. And yet you're rushing to work in the morning. You're dealing with either traffic or you're taking a train or a subway. And then there's maybe you live in a city and there's noise, there's honking there, construction noise. And that to me is what I call biophysical stress. So there's the mental emotional stress that comes from interpersonal relationships being upset about something with your spouse, children, whatever it may be with a friend. But there's also the biophysical stress that we take in without even realizing it, because a lot of people are living in big cities and there's a lot of noise and commotion. So one of the the very healing things I think people can do to distress is to get out in nature. So it's really finding what speaks to the person, but I think not enough people put. Enough emphasis on kind of like active, distressing, you can't just expect it to happen, and I know a lot of people use the TV at night as their form of distressing, but honestly, that's not a positive distress for the body. To me, watching TV is kind of like an onslaught. It's like constantly changing commercial, even programs. They're they're always changing. You watch the news and they have one snippet and then they go to the next thing. And then the next thing that to me is I would classify that under biophysical stress and talk about even blue light exposure at nighttime and how that affects the the circadian rhythm. But you really need to get more organic return to your humanity in order to distress. And meditation can be a part of that. But even going to a ballroom dance class, I find what really speaks to your soul and enhance that, because the more you're able to do those things and things that you enjoy that are positive for you, then it's another way that you create health and wellness in your body.
Awesome, well, that is amazing that the top three tips is all about slowing down, meditating, distressing, and you're not really as much talking and I know that's a part of it, but that the top three are the slowing down, meditating distressing. And then comes what you put in your body.
Well, let me explain, because I have the patients who come in and they're doing everything perfect. They're like crossing their t's, dotting their eyes. They're eating the perfect diet. They're taking all the supplements, but they are wound up as can be. And I am convinced after years of doing this, that if you do not address what I call the elephant in the room, which is the stress, it is our disconnection with our human bio rhythms, that is part of the reason that disease takes place in the body. So it's really about reconnecting with our our organic, almost like our animal nature. We are these these very highly advanced beings. But we are still. These we are still, in essence, kind of we are animals at the same time, and I mean that in a very organic way, that. We need to be connected with each other and we need to be connected with nature in order to be healthy.
Wow. Well, in my newest addition of my book, Waste Away, I talk about how people don't have to deprive themselves when it comes to food, but everyone needs to decide for themselves, what are there, red light, yellow light and green light. And so red light are things like when you eat this, you know, you feel terrible. Your guts inflamed yellow lights. Like, I don't feel great. I don't feel terrible. So what are those red light yellow light foods for you personally?
Yeah, I love that because I hate and I love that you call it yellow light. Red light. And because I hate the idea of deprivation, you know, I kind of more tag myself to the idea of choice. And then when you're making a choice, so say you're pro your health, you're making a choice for your health. And that choice involves you not eating a red light food. Then you're not really depriving yourself. You're actually making a really positive choice in favor of yourself. You know, I think a lot of people get really. Stuck up with the idea like, oh, I can never have this again, and I think if you can only let go of that and just say, well, I'm choosing for my health, and that might mean that I'll never eat that red light food again or very rarely, like maybe once a year. But that's OK. I don't miss it because I am putting myself as my primary focus and I love myself enough to not do that damage to self. So my red light food is actually wheat gluten and it took me a long time to figure that out. I had been on multiple, multiple rounds of antibiotics as a teenager. My parents and my pediatricians knew no better. It was part of the gestalt, the way that they thought you have an infection, whether it's viral or not, and just take an antibiotic that's going to knock it out. But what it did is it destroyed my microbiome and it caused leaky gut syndrome. And that then allowed me to develop a sensitivity to wheat gluten, which was one of the top food groups in my diet as a as a teenager growing up. And it took me probably more than a decade to figure that out. And when I finally did, I took wheat gluten out of my diet. And after I did a blood test, actually, that showed that I had immune reaction to gluten. So it took that much for me. I was like I needed that extra motivation as a guy. Like I needed to see on paper that I was actually reacting to this food. And after three months, I tested it. I had I was out to brunch and I had some rye toast. I really love rye. And as within ten minutes of eating it, I developed a rash on the insides. Really, really like a rash on the inside of my wrist. And it started itching and it was super light. But I thought, oh, that's interesting because I've never had a rash on the insides of my wrists. And the only thing that I did different was I reintroduced gluten today. I tried out some some bread. So I avoided it for another three months and decided, OK, I'm going to test it again, let's see if my gut is healed, if I can handle it. And lo and behold, same thing. Faint rash itchiness on the inside of my wrists, so I realize, OK, this food is not doing well for me, it's causing some sort of inflammatory reaction. And I knew that when I ate it, I felt mentally foggy. I didn't feel well. So after that, I decided I took it out for another six months, then tested it. And honestly, I think when I got to the end of the year, I was feeling so good. And this is the thing that people don't realize is when you avoid a red light food, you think you know how you're going to feel at one month of avoiding it. And at six months it it even gets better. I mean, it's it takes a bit of time to unwind the immune system. And really at a worse time, I felt so good off of wheat that by then it had become a choice to not even introduce it. And sure, there were cheap moments like if I was happened to be at some cafe that makes their own dollar French toast, then they make it fresh. They're their own bread, like yell, I'll treat myself. I mean, I don't believe in in holding such strict dogma that you never allow yourself something because then that leads to those deprivation feelings and then to bingeing or really falling off the wagon, which I see happens a lot with my patients. But I had the French toast and the next day or two I had a little bit of aggravation of my IBS and I know, OK, I'm I'm paying for it, but I sure as hell enjoyed it. And but I'm not going to continue and I'm going to keep that food is in my red light. So that's going to be for very rare occasions, yellow for me. So wheat is kind of like my primary red light, I would say, and yellow would be dairy. And the way I deal with dairy is I'm basically a seasonal dairy eater. So I have found that the time of year when Derek is going to have the least reaction for me is during the summer months, and that is because in the fall, winter, spring dairy is going to cause more mucus buildup.
It's going to weaken my immune system. It's going to make me more susceptible to viruses and flu. And if I'm having dairy in the spring, I'm going to start sneezing and I'm going to develop allergies. When I finally figured this out and remove dairy during the fall, winter, spring season, I stopped even knowing that spring allergies existed unless it was like a really high pollen count day where the pollen gets stuck on the insides of your eyelids and your eyes start to feel a little gritty and irritated. But all my allergy symptoms disappeared by taking dairy out. So that one is another one. I love cheese. Like I wish I could eat cheese year round sometimes because there are exceptions. So with dairy cow, dairy is going to be the most antigenic and they've done testing on this. Goats and sheep milk is not as allergenic, it's not as allergy producing as some of the other milks because of the kassin protein. And go to and sheep is more similar to human milk. So the so I might have feta cheese in the winter if I'm really missing some cheese or goat cheese or Manchego. But here's a question to know which one which animal milk is the most like human breast milk and has the least immunological reaction. When they did, they did a study looking at across like I think it was a group of 50 different healthy volunteers.
I'll take a guess. Camel milk, yes. Is that right?
Yeah, camel milk.
Oh, my gosh. I think I heard that somewhere a long time ago. So that's funny that I remember that. That's awesome. Yes.
And they're using camel milk a lot in the autism community because they found that it has healing factors that I mean, and this is not homogeneous, not pasteurized, actually raw. So you have to make sure you're getting it from a really good source. But it has a lot of healing factors that can help reverse some food allergies by drinking camel milk. So it's pretty, pretty crazy. Fascinating that it's very close to human milk and it's the least antigenic out of the milk. Some people even still will react to nut milks. So you have to be you know, when it comes to eating, I think one thing that I teach is that people need to be really intuitive and listen to their bodies. But there's a lot of people, don't they? They eat something. They feel horrible, but they're not hearing the message and they'll eat it again or they'll eat the same type of food. And they're like, well, I don't know what's making me sick. It's like, well, you really just have to pay attention and listen to your body and think, you know, wheat and dairy, those are the top ones across the board for a lot of people that I see.
But there's other foods that people might react to. And really now it's not hard for me to stay in the green lane because I put the the greatest priority for me is feeling good day by day, day after day. And when that is your priority, then it becomes really easy to eat healthy, because why would you eat the things that are going to make you feel sick the next day or even even depressed? Like people don't realize that too much sugar can actually cause depression because it puts you in that, you know, the the sugar spike and drop roller coaster. And that causes a lot of that's causing almost like an internal climate changes that the body interprets on an emotional scale as anxiety, depression. You can get irritable, reactive, and you don't realize you think it's you or you might blame it on the other person, but it could be the way you're eating that's causing that.
We've had different guests on the show and they've talked about gut health and as some of them are really big Kembu fans and they say, you know, it's so good for the gut. And then there's others that say, you know, there's just no evidence yet of the probiotic benefits of Cambodia. And so what is your thoughts on this? Are you a fan of it? Not a fan?
I think cautiously, a fan. I mean, I love kombucha, but I tend to drink it in shots. So those just come in bottles that can be this big or they can be really giant bottles. And but in my opinion, which is not really meant to be drunk as like a regular drink that you would drink a full glass of, really, it's it's just meant to be drunk and in small shots. And but you have to be careful with it because four people have a yeast sensitivity or Candida Caboolture can actually aggravate their symptoms and a lot of the butcher's on the market have way more sugar than you should be having, and especially if you have yeast issues or just biases. But they've tested the brands and some of them actually have more sugar than is what is listed on the label. So you have to be really careful with the brands and how much sugar is in there. And that's why I usually if I drink kombucha and honestly, my my weakness is ginger lime. That is my favorite. But if I drink it, I only drink it in small shots, maybe like after dinner. As a digestive, I love having a little bit of ginger kombucha, but I don't think it should be drunk in large quantities. There's good research otherwise on Kiffer and how Kiffer is going to have much higher colony forming units, curfews of of favorable bacteria. And they've done studies on Kiffer and how it lowers anxiety scores by having a cup of coffee for every day. They studied women in England and found that their anxiety scores dropped. And they think because the type of bacteria and kiffer will produce Gabb, which is an amino, basically a neurotransmitter that lowers anxiety by kind of it's sort of shushes the nervous system. It calms everything down. So there are benefits to Kiffer, but I don't think the research I would say is still up for Booch. And you have to be careful because a lot of the ones in the market have way more sugar than someone should be taking. But still, at the same token, computers don't have as much sugar as a soda, for example. So between a soda and kombucha, I would choose kombucha.
Well, let's jump right into the listener questions, we got two questions today, this morning, and we've never had a question on this before. One is from Frederick in Gainesville, Virginia, says, I have been diagnosed with Gyver diverticulitis. It's a type of disease that affects your digestive track. It causes inflamed pouches in the lining of your intestine. Do you have any real medical doctors to say if there are any natural ways to heal this without traditional medicine? And then we got another one from Marlan, a Meggan, and says, do you have any podcast talking about diverticulitis? So I was like, wow, we got two questions on that said diverticulitis questions.
And one, well, let me first let me first define. So diverticulitis is really is an acute infection that happens in the colon. So and really the underlying condition is called diverticulitis, which are basically out portions of the colon. So if you think the colon is this long, too, it's about maybe about six, five, six feet long. And it's it's got like undulations. But sometimes if a person's been chronically constipated, for example, and too much pressure builds up or they're straining the lot to have bowel movements over time, pieces of the wall of the colon can become weak and they create like a little pouch that sticks out from the inside. So on from the inside, it would look like a small opening. And it's an outpouring of colon that's diverticulitis and itis. Any IDUs in the body is when there is inflammation. So if bacteria get into that pouch, then they can become infected and that can actually become a medical emergency. Worst case scenario, the person has to go for emergency surgery and have a piece of the colon taken out if it becomes really inflamed and gangrenous. But most of the cases can be treated with antibiotics and a lot of. So since I do functional medicine, everything is about treating the underlying cause. So the underlying cause is usually for these patients, constipation and straining, probably not eating enough fiber. The average American gets about 10 to 15 grams of fiber a day, but we should actually be getting twenty five to thirty five grams per day. And if you look at like Hunter-Gatherer societies like the huts of Tanzania who are still there's about at least two hundred and fifty of them that still eat the traditional diet, but there's about a little over a thousand that still live the traditional Hunter-Gatherer lifestyle. And they're eating around 50 grams of fiber daily, sometimes even higher, like even all the way up to 100 grams. So we're really not getting I mean, our food has been processed and deprived of fiber, a lot of white breads and processed grains. They've taken out the fiber. So first, my first advice is to really increase the amount of fiber in the diet. And if you're going to increase fiber through things like roughage, greens, dark leafy greens, but also soluble fibers like the ones that are found in steel cut oatmeal, you want to make sure that you also increase your water and takes a lot of people don't drink enough water. You should be getting at least around 60 for fluid ounces of water per day, which is eight glasses of water. But if you're drinking three cups of coffee, then you're probably dehydrating yourself much more and you need way more water to keep yourself hydrated. And you'll know because if you're still is coming out really firm and hard, then you're too dehydrated. And there's other things like you can always add omega 3s into the diet fish oils to kind of that helps lubricate the stool as it goes through and it helps keep it from getting too hard. And you want to be careful about eating things that are things like seeds and nuts that could be get lodged into that little out pocketing.
And that's the theory of how it might become infected, that it gets blocked and then it builds up bacteria in their.